Wednesday, 15 April 2015

What do nurses actually do?

Roger Watson, Editor-in-Chief

We all think we know what a nurse is and most think they know what a nurse does. But is this the same globally? Even in one country, the range of what any group of nurses does is wide, ranging from 'basic' care to minor procedures and prescribing. In the UK, for instance, what a nurse does in one hospital may be specific to that hospital and may not apply in another. This phenomenon is referred to as the 'scope of practice'. Therefore, it is logical and essential that we study this and, as the authors of this study, Kennedy et al. (2015), say: 'regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction'. The study to which I refer is titled: 'Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision-making frameworks: a discussion paper'; it was carried out by a team in Ireland and is published in JAN.

Twelve international regulatory frameworks were reviewed in detail following a systematic process of retrieval and the sources are summarised in an extensive table. The study found that the approaches to developing scopes of practice did not emphasise patient choice and focused on the technical rather than the aesthetic aspects of nursing. The authors conclude: 'Such frameworks are predicated on the practitioner being familiar with legislation and guidelines that regulate and control practice and that may enable or prohibit role expansion. They are also predicated on individuals having sophisticated skills in reflection and self-judgement in relation to their competence, knowledge and skills.'